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1992, 07-24 Permit App: 92005650 AC
(45 X53. Y \a� c JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: 7/'0•^ o MECHANICAL PERMIT APPLICATION FORM Information Worksheet -7`i7 9a-5(050 7?5 9 9 2-/ 4 PARCEL NUMBER: /' /a/ r PHONE NUMBER: 714 MAILING ADDRESS: CONTRACTOR: yy z-( (Street) (City/State) Ranner Furnace !r Fnal , Inc .LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE MAILING ADDRESS: P• 0. Box 4346 (Zip) PHONE NUMBER: 535-1711 Spokane, WA. 99202 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVEJINSERT GAS WATER HEATER •GAS EQUIPMENT.,<100,000 BTU'(INCLUDES :.:.,' GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET)- BOILER/REFRIG 1-100M BTU BOILER/REFRIG:101-500M BTU, BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG1,0001-1,750M BTU. BOILER/REFRIG +1,750M BTU I+r & AIR CONDITIONER O3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 15=30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &'AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS_'.: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE-_ - GAS LOG MISCELLANEOUS (NOT COVERED: ELSEWHERE .. „ UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU ',', AIR HANDLER <10,000 CFM AIR HANDLER >10,000'CFM • NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x 60.00 = x12.00 = % /Aro 2 x 20.00 = x 25.00 = x35.00 = x 60.00 = x10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ /L i'a + $ 25.00 PLUS: PROCESSING FEE EQUALS: TOTAL'PERMIT FEE DUE _$ 3?-'° Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675